Background: Pain neuroscience education (PNE) combined with exercise and mobilisation with cognitive goals presented decreases in pain and disability and an increase in spinal function compared to physiotherapy intervention in patients with chronic low back pain (CLBP). Objectives: To investigated the effect of forward head posture (FHP) with chronic neck pain on the PNE combined with cervical and thoracic mobilization. Design: A randomized controlled trial. Methods: The subjects were randomly allocated to the MDT with PNE group (MPNEG, n=15) and the PNE group (PNEG, n=15). Pain neuroscience education was provided to both groups, and MDT exercise was additionally performed in the experimental group. Training was conducted 3 times a week for 8 weeks, and the Oswestry Disability Index (ODI) and numeric rating scale (NRS) were used to measure the level of back pain dysfunction, and each was evaluated before and after the experiment. Results: Results from the study indicated that statistically significant decrease in NRS and ODI in MPNEG. In PNEG, there was statistically significant decrease in NRS. And in MPMES, there was a statistically significant decrease in ODI than in PNEG. Conclusion: The MDT combined with PNE is more effective than PNE alone as a treatment method for improving lumbar dysfunction and reducing pain in chronic low back pain.

Background: Clinical practice guidelines for patients with chronic low back pain (CLBP) recommend therapeutic exercise, and recently, interventions for pain neuroscience education (PNE) are also recommended. Objectives: To investigate the effects of aquatic exercise combined with PNE on pain, disability, and fear-avoidance beliefs in patients with CLBP. Design: Randomized control trial. Methods: The 27 participants recruited in this study were randomly allocated as pain neuroscience education combined with aquatic exercise group (PAEG, n=14) and aquatic exercise group (AEG, n=13). Both groups performed aquatic exercise for 50 minutes, 3 times a week for 6 weeks, and only PAEG received additional PNE. Numeric pain rating scale (NPRS), modified oswestry disability questionnaire (MODQ), and fear-avoidance beliefs questionnaire (FABQ) were used as evaluation methods before and after intervention. Results: Statistically significant decrease in NPRS, MODQ and FABQ (physical activity and work score) before and after intervention in PAEG. However, there were statistically significant changes in NPRS, MODQ and FABQ (physical activity score) before and after intervention in AEG. PAEG and AEG before and after intervention indicated statistically significant differences in MODQ and FABQ (work score). Conclusion: Aquatic exercise combined with PNE improved disability (MODQ) and fear-avoidance beliefs (FABQ) has been shown to have additional benefits. Therefore, combining PNE as a clinical intervention for CLBP patients will enhance the therapeutic effect.

Background: Pain Neuroscience Education (PNE) is an educational approach that deals with the physiology of the nervous system as well as the pain system and refers to educating patients with chronic musculoskeletal disorders such as chronic back pain. Objectives: This study examined the effects of pain neuroscience education on patients with low back pain. Design: Systematic review. Methods: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify randomized controlled studies. In the final outcome, 43 publications were identified, and 13 studies met the inclusion criteria. Results: There were a total of 13 pain-related studies, including 11 studies using NPRS (VAS) and 2 studies using other pain measurement instruments. In NPRS, the effect size was 0.683, which had a medium effect size. In Roland morris disability questionnaire (RMDQ), the effect size was 0.544, which had a medium effect size. In Oswestry disability index (ODI), the effect size was 0.951, indicating a large effect size, but the confidence interval could not be obtained because there was only one study. Conclusion: Pain neuroscience education has positive effects on low back pain and disability index in related patients.

Background: Research has been conducted on pain neuroscience education (PNE) for the relief of pain and symptoms associated with chronic neck pain (CNP). Focusing on the neurophysiology and neurobiology of chronic pain, pain processing, and particularly the function of the central nervous system for chronic pain, PNE helps patients to understand the causes of pain. Objectives: To investigate and systematically review interventional studies on the effectiveness of PNE for patients with CNP and to analyze the effect size by performing a meta-analysis. Design: A systematic review and meta-analysis protocol. Methods: The following databases and electronic collections will be searched for primary studies without time limits: PubMed, MEDLINE, OVID Embase, and CENTRAL in the Cochrane Library. Reference lists from identified studies will be manually hand-searched for additional relevant works. Patients 18 years of age and older with nonspecific neck pain lasting 3 months or longer will be included in the study, with exclusion criteria as follows: cancer pain, fractures of the spine or surgical intervention, cognitive impairment that does not allow the patient to follow the PNE program, pregnancy, chronic fatigue syndrome, fibromyalgia, and other related pathologies that may prevent full participation in the PNE program. There are no geographic restrictions; however, non- English studies will be excluded. Discussion: This study aims to evaluate the effects of PNE on pain and disability in chronic neck pain. Its results will help clarify whether the use of PNE alone can improve chronic pain. The advantages of systematic reviews include clear definitions and inclusion and exclusion criteria, standardized search formats, and objective independent reviews.

Background: Pain neuroscience education (PNE) with other therapeutic approaches can reduce pain intensity in patients with Chronic musculoskeletal pain and chronic spine pain by improving quality of life and disability. However, in various clinical trials and reviews, the optimal dose of an intervention combined with PNE is still an area to be studied. Objectives: To investigated the effect of forward head posture (FHP) with chronic neck pain on the PNE combined with cervical and thoracic mobilization. Design: A non-randomized, controlled intervention study. Methods: Thirty-two subjects were allocated to pain neuroscience education combined with cervical and thoracic mobilization group (PCTMG, n=17) and cervical and thoracic mobilization with TENS group (CTMG, n=15). For 6 weeks, the PCTM group applied PNE and cervical and thoracic mobilization and the CTM group applied cervical and thoracic mobilization and TENS. Changes in intervention pre-post pain and kinesiophobia were observed. Results: Results from the study indicated that statistically significant decrease in VAS and TSK-11 in PCTMG. In CTMG, there was a statistically significant decrease in VAS. And in PCTMG, there was a statistically significant decrease in VAS and TSK-11 than in CTMG. Conclusion: Therefore, this study confirmed that PNE combined with cervical thoracic mobilization is an effective intervention compared to ervical thoracic mobilization alone in reducing pain and kinesiophobia in FHP with chronic neck pain.

Background: A recent study found that pain neuroscience education (PNE) alters pain intensity, knowledge of pain, disability, psychological function, and pain behavior in patients with musculoskeletal pain. However, they noted that PNE alone was not sufficient to affect chronic low back pain (CLBP) reduction. Objectives: To investigated the effect of CLBP on the PNE combined with lumbar mobilization. Design: Quasi-experiment study. Methods: A total of 33 patients aged 25 to less than 65, recruited from L-hospital for low back pain in Chungcheongnam-do. Out of 33 subjects, 17 were pain neuroscience education combined with lumbar mobilization group (PLMG) and 16 were lumbar mobilization group (LMG). The outcome was visual analogue scale (VAS), oswestry disability index (ODI) and the fear avoidance beliefs questionnaire (FABQ). The collected data was analyzed using the SPSS ver. 21.0 program by paired t-test and independent t-test. Results: PLMG was indicated statistically significant decrease in VAS, ODI and FABQ before and after intervention. However, there were statistically significant changes in VAS and ODI before and after intervention in LMG. PLMG and LMG before and after intervention indicated statistically significant differences in VAS, ODI and FABQ. Conclusion: The inclusion of PNE combined with lumbar mobilization in patients with CLBP is a promising and feasible approach to the management of CLBP.